The Development of a Scoring System for Acute Variceal Bleeding Risk in Cirrhotic Patients in Emergency Departments

To identify independent clinical predictors of acute variceal bleeding (AVB) in cirrhotic patients and to develop a rapid, non-invasive scoring system to facilitate objective risk stratification and resource prioritization in emergency departments (EDs).

This retrospective study focused on the development of a scoring system based on the international normalized ratio of prothrombin time (PT INR) and end-stage renal disease (ESRD) hemodialysis (HD) status to aid in predicting acute variceal bleeding.

In our study involving 319 patients, we report an association between a prolonged PT INR (OR 1.73, 95% CI 1.03-2.91; p = 0.038) and the absence of ESRD (p < 0.001) and an increased risk of variceal bleeding. The resulting risk-scoring system, while preliminary, ranges from 2 to 14 points and shows promise, with an AUC of 0.89 suggesting its utility in emergency departments.

This scoring system, although in its early stages, may be a beneficial tool in emergency care for patients with cirrhosis. Its practicality and potential efficiency could aid in better patient management. However, broader validation in diverse clinical settings is essential to confirm its applicability and effectiveness.